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General NPI Number Information
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NPI Number | 1710565676
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Entity Type | Individual
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Provider Name | TAYLOR BRYAN FARISH DO
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Gender | Male
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-7709
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Country | US
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Telephone | 214-648-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 4861 CANARY DIAMOND AVE
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City | LAS VEGAS
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State | NV
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Zip | 89139-7147
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 8858
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License Number State | OK
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